Likely cause of mystery child hepatitis outbreak found | Hacker News Reader

Likely cause of mystery child hepatitis outbreak found

bbc.co.uk

100 pointsiamben171 comments

I hope that the legacy of covid lockdowns is a renewed appreciation for the second-order, systemic, and unintended consequences of any action, to be weighed against the direct and intended effects.

And that the number of cases of people with repeat infections and long covid is considered in assessing whether these lockdowns and restrictions should have been lifted and the disease allowed to spread freely.

You would need to counter-balance this with the likely models of death and long covid if lockdowns _hadn’t_ occurred as well.

You cannot look at the actual stats without taking those mitigating factors into account.

You aren't going to shelter in place a highly contagious airborne virus. Life is not risk free and it's beyond obvious that lockdowns did FAR more harm than good.

I find myself despairing that almost no lessons were learned, no clear institutional improvements came from these systems.

The response to monkey pox is bearing that out. A subset of the left (my team) saying “asking gay men to stop having orgies is homophobic”, totally isomorphic to “being worried about COVID is racist against Chinese people”, one of the initial lines.

Then you have the total failure to mobilize an institutional response for contact tracing. There’s not apparently any infrastructure for it, despite how monumentally useful such a thing could have been, would be now. I don’t want another endemic smallpox-related virus, and this virus having lots of hosts to evolve in has some clear second order risks.

Likewise, the hostility towards masking is owing to some substantive inability to evaluate second order risks.

The initial lockdowns, I think, hold up pretty well in retrospect. Closing schools never really made sense for the children once it was identified that the virus attaches via ACE2 receptors; keeping the schools open was a lot less clearcut for the teachers. You don’t become a schoolteacher because of your high appetite for risk.

> The response to monkey pox is bearing that out. A subset of the left (my team) saying “asking gay men to stop having orgies is homophobic”, totally isomorphic to “being worried about COVID is racist against Chinese people”, one of the initial lines.

Asking gay men to stop having orgies isomorphic to asking people to put on masks.

Randy Shilts' book And the Band Played On spends a lot of time on exactly this problem during the early days of AIDS. Closing the bathhouses was controversial and resisted for too long.

Some countries did seriously try contact tracing for COVID-19 and it was generally a waste of resources. Most contact tracing programs have now been discontinued or scaled back. China is still doing it, but their approach requires an authoritarian surveillance state which is far worse than any virus.

>an authoritarian surveillance state which is far worse than any virus

I'd take any authoritarian state over ebola, thank you very much.

The irony of seeing this reply in a thread started with hope for "renewed appreciation for the second-order, systemic, and unintended consequences of any action" is darkly comic.

The first-order effect of ebola is (almost) certain death. No need to consider anything of higher order.

The fatality rate for ebola is around 50%.

https://www.paho.org/en/topics/ebola-virus-disease

Even at that rate, I would rather take my chances with ebola than live under a communist regime.

https://victimsofcommunism.org/

It's not, it's about a coinflip (as the sibling reply noted). But you're making a very salient point about the ease at which higher order thinking can be shut down en masse in a population through fear.

Is there an authoritarian government in the history of humanity that managed to kill 50% of its population? What's the average?

Yes, there are situations in which "higher order thinking" doesn't matter.

>Is there an authoritarian government in the history of humanity that managed to kill 50% of its population?

That's the sort of higher-order question you'll be able to find out right after the magical Ebola wave, if you embrace authoritarianism.

Got it, "higher-order thinking" is the new reincarnation of "doing your own research". Not that surprising, actually.

In that both are exemplary qualities, only talked down by people who — by laziness or ulterior motive — would rather see them outsourced?

No, in that both are usually repeated by clueless charlatans.

Can confirm. Whatever the success of other public health measures in NZ, contact tracing was insanely high cost if done manually (and spinning up new contact tracers was much harder than it sounds). The Bluetooth and "scan here" tech solutions never seemed to get widespread adoption by users, and for a reason I've never heard explained, seemed rarely used by the health administration.

Not sure if the risk/benefits analysis is that simple, because the risk/benefits evolve over time. At the beginning of a pandemic it is definitely beneficial, but it changes when either spread is too high, or other measures (vaccines, therapeutics) become available. This is evidenced by the fact that contract tracing continues e.g. for monkey pox.

There's also the difference in transmissibility between the original virus and the later variants. Contact tracing something with an R0 of 5 is a different matter than tracing one of 15.

“asking gay men to stop having orgies is homophobic”

Of course, nobody on your team said that, nor did they say "being worried about COVID is racist against Chinese people" Why did you choose to lie about this?

Okay, I'll say "I think unvaccinated people should not be having orgies", I'll wait to see if anyone says that's homophobic. Yes I actually think the statement is true, I'm not just making a point. Edit: I guess I should be more constructive, an action gay men could take is demanding their states order enough doses of ACAM-2000 from the Strategic National Stockpile to cover everyone who can take it in their community (so no HIV, skin disorders, heart disease, etc). Leave MVA-BN for people who can't take ACAM2000.

I had an account on Reddit /r/news get banned because I said we should suspend all international travel to China at the start of COVID.

This was when democrats were making apology tours telling everyone not to be afraid to go to Chinatown.

There were several months at the start of 2020 where the “progressive” authority would systematically attack you as racist for being worried about COVID.

I'm definitely not lying about this. See: https://twitter.com/Esqueer_/status/1550856205706338305 Also see sibling comment.

You can _also_ find people saying the lack of response is because of homophobia, and this is the thing that makes me want to flip a table: the WHO describing reality is morally culpable and causes homophobia per that tweet, the lack of effective response is homophobic, emphasizing the actual events that have had a causal role in the outbreak is homophobic. Homophobia/whatever flavor of the day is the a-priori conclusion, work backwards from there.

When you bring up the excesses of this cultural movement, you're told

1. it's not really happening

2. you're just nut picking, or

3. it's actually good.

and it's so often tied up with accusations of lying or dishonesty. Like, everyone is so mind poisoned at this point we can't just _disagree_, it's got to be an issue of mendacity or moral corruption.

I'm definitely not lying about this.

The statement “asking gay men to stop having orgies is homophobic” is obviously not the same as the statement "emphasising the focus on men who have sex with men…will lead to a dark place with rampant homophobia", particularly when backed up with lots of examples of exactly that thing happening!

It's not that "everyone is so mind poisoned at this point we can't just _disagree_". Indeed, I don't even disagree! I generally think that health authorities do need to understand and talk about community-specific risk, while ensuring that they balance that messaging with the impact that this can have. On the other hand, my own fucking grandmother is now under the impression that I am now at risk from a magical gay disease that's sweeping through the country because of how ham-fisted the communication has been.

The problem is that instead of talking about what your concerns were (while taking on board other points of view on the issue and how complex it is) you jumped directly to making up a quote that justified what you already thought. If you want to find a thing that is going to make "everyone is so mind poisoned" then that is what's going to do it.

>Closing schools never really made sense for the children once it was identified that the virus attaches via ACE2 receptors

After bemoaning failure to consider second-order effects this seems like making the same mistake - It was a good news that kids were less susceptible to severe infection but protecting children was not the sole purpose of closing schools. Kids were still susceptible to infection and could still spread the disease to adults. Schools were a mixing pot for kids to get infected and then go home to infect adults who might then suffer more severe effects.

I think even in retrospect it holds up very well as an effective means (amongst many others) of slowing spread.

Real lesson to be learned is to open lockdowns and remove restrictions gradually.

"Open schools and kindergartens" is not gradual.

That first summer lots of kids went to sleepaway camp and caught the virus there.

Then instead of just staying at the camp where it would be contained and burn itself out, the camps themselves shut down and sent everyone home on regular commercial flights. Completely inexplicable and inexcusable.

I mean, I think my real complaint is that

1. humans are fuckin' terrible at thinking through second order effects, and 2. often they are simply unknowable a-priori

so to the extent that I am doing the thing I'm unhappy with, it's less hypocrisy and more accidentally proving my broad point.

At any rate, about kids: the same reason kids aren't especially susceptible to COVID seem to also substantially reduce their transmission of it. It might be the case that it's still worthwhile for the broader community, idk - I'm certainly default a little skeptical of anyone saying "think of the children!"

> the same reason kids aren't especially susceptible to COVID seem to also substantially reduce their transmission of it

In hindsight, maybe, but there were a lot of unknowns in March of 2020 and that was one of them.

oh, totally - my post also said I thought the initial lockdowns were fully justified and correct, and that only after the discovery of the ACE-2 mechanism did the calculus for children having schools open change (for me)

Bars were open. Whatever impact school would have on transmission was dwarfed by bars.

> Likewise, the hostility towards masking is owing to some substantive inability to evaluate second order risks.

Funny, that's how I would describe the widespread insistence that we can indefinitely conceal half of everyone's faces in public (when the only effective masks are ones which create a large amount of plastics pollution), or assiduously suppress the spread of pathogens, without having some as-yet unknown knock-on effects. It's bizarre that so many treat these things as unalloyed goods with zero downside whatsoever.

I don't view them as unalloyed goods, for sure - it's just that most of the hostility came pre-anyone having great arguments against them and struck me as fundamentally tribal - went into an ice cream shop with my girlfriend in Ocala, Florida, got glared down as the only people wearing masks. This wasn't well considered social pressure, it was most assuredly "we don't cotton to them types around here."

I do think the arguments against wearing masks when interacting with children/making children mask have been quite strong, post ace-2.

We need a billionaire to start funding boarding schools, where the kids and teachers can be isolated from the rest of the public.

It's probably not as cut and dry as we'd like it to be. How do you weigh a number of children with hepatitis vs people missing out on care because hospitals are overwhelmed with covid patients (in a world where there were no lockdowns)? Can we confidently say "lockdowns were bad because X children got ill and only Y people would have suffered from hospital-collapse"? Or the reverse?

I agree, it's difficult to evaluate, and I think we would benefit from recognizing the difficulty, and acknowledging that there were a lot of sound arguments being made both for and against lockdowns, and that the decision was a grave one. I supported the initial 2020 lockdown, and I lament that it did not come sooner, but I also don't hurl vitriol against those who delayed the decision, because I know that their motivation was not malice, but balancing the totality of needs.

You could be right. How much of the reported hospital overwhelm was due to children being admitted with primary Covid infection?

Lets also appreciate that second-order effects are smaller than first-order effects.

This particular second-order effect affected 1000 people in 35 countries.

Not small for the parents of those 1000 children I'm sure.

One of my children is currently very afraid of statistically unlikely events causing him harm or death. Part of life is evaluating choices for likelihood of harm and deciding if that is an acceptable risk.

I’m not saying this or that about the causes that led to this illness, but 30 cases per country is a bit hard to justify as an input to decision making, especially at a community or country level. It’s valuable information, but if we hid under the sheets for everything that affected a small portion of the population, we’d all have bed sores.

Appreciate the irony that the people in favor of taking no actions against covid because the probability of dying is so low are the same people in this thread crying over 1000 people worldwide.

And that's why we need to ban encryption /s.

I’d wager the vast (99.95%+) majority of kids who were kept inside to protect them from Covid, have gotten Covid by now or will get it and recover, meaning that will they have Covid immunity AND were denied the opportunity to better avoid this hepatitis infection.

I think you misread the article, granted it buried the lede. The suspect is an instant hit of multiple (in this case two) infections at the same time, when in normal conditions only one at a time would be likely.

The solution to this issue is both unlocking lockdowns more carefully to detect such problems, and deploying vaccines if such a problem is identified.

If the problem was ending the lockdowns, why don’t we just live in a permanent state of lockdown? With mandatory vaccines? Seems like that would work

Not practical, unfortunately. Plus, in typical conditions, neither of the viruses is highly problematic. Only when you get both at the same time you're more likely to suffer, and when unvaccinated to either.

Kind of the same problem with COVID, it can also contribute to a terrible secondary infection. In this case, quite some time after even recuperating from it.

To add to the thought experiment: If it were possible to isolate every single human being (and animal etc.) a considerable number of pathogens would die out.

That's a fake account spinning the narrative.

More than likely we'll forget all about it in 10-15 years time and will repeat the same mistakes. Science will see it but governments won't.

> Science will see it

Sure if they create the next one too I suppose they'll "see" that one too.

In Canada, so-called scientists, academics, and medical doctors have consistently been among the most vocal initiators and proponents of the obviously-idiotic and useless restrictions that have caused widespread harm.

They've also been among the most vocal proponents of censoring and silencing any opposition or questioning of their claims.

We've seen a massive amount of anti-scientific behaviour from the "science" community.

How do you model for unintended effects? You can only operate based on the knowledge you have at the time.

Alternately, if the US and other countries hadn't half-assed their response with the pseudo-lockdowns, the "lockdowns" would have been far shorter, fewer, and farther between. Nobody advocated for months-long "lockdowns" where the upper socioeconomic groups would stay home and pretend they were on a fun vacation while the rest were crowded into shipping facilities, food packing plants, and so on in order to make the "fun vacations" possible.

I think this is the actual paper: https://www.medrxiv.org/content/10.1101/2022.07.19.22277425v...

And be careful before attributing this to COVID lockdowns. In the US, at least, there does not actually appear to have been any meaningful increase in hepatitis in young children:

https://www.cdc.gov/mmwr/volumes/71/wr/mm7124e1.htm

The UK could be different for any number of reasons, but, at least in the actual paper and in the US, this does not appear to be COVID-related, even indirectly.

I'm just concerned that we are not having the debates we used to. They've already coined the term "immunity debt" and Twitter accounts belonging to researchers who are raising alarms about jumping to early conclusions attributing this to lockdowns are curiously enough being brigaded.

I'm not saying one thing or the other, I just want to get a nuanced view that is backed by data but hard to do that when those links are getting removed from the platform.

I'm just puzzled as to why this is happening

The data itself is a mess. There are no consistent reporting standards or definitions between countries, or even between states.

I don't understand why a slightly delayed exposure to some "common" viruses can almost destroy the liver of young children.

It’s similar to chickenpox in that it’s much safer to be exposed younger, but in this case it’s more pronounced

Most kids nowadays (hopefully) get the chickenpox vaccine and never have to suffer from it or shingles as adults.

Not in the UK, where the chickenpox vaccine isn't part of the vaccines given by the NHS.

Wow. I did not peg the NHS as an anti-vax organization

Not anti-vax, they don't want to spend money on something like that. There's a reason the USA spends lots of money on healthcare and the UK does not (though it's obviously relative on a country scale). It's not through magic, it's through spending less money. Spending less money in a healthcare system demands sacrifices, some quite severe.

They have a detailed explanation here https://www.nhs.uk/conditions/vaccinations/chickenpox-vaccin...

Not sure if irony/sarcasm will lead to a more productive discussion.

FYI chicken pox is not part of the routine vaccine schedule (in the UK) to protect unvaccinated adults:

"There's a worry that introducing chickenpox vaccination for all children could increase the risk of chickenpox and shingles in adults."

https://www.nhs.uk/conditions/vaccinations/chickenpox-vaccin...

>Not sure if irony/sarcasm will lead to a more productive discussion.

Productive discussion, perhaps not. Productive thought, I believe so. If it penetrates the reflexive defensive barrier that so many have around polarizing topics, that’s a win

I see your point, and if I understand you correctly, it is evidenced by the success of the Twitter/Tik-Tok/etc. recommendation algorithms.

I'm just not sure we need productive thoughts more that productive discussions, given that we will face more collective 'resource allocation problems' over the next decades.

That’s quite regrettable. It’s a safe vaccine that totally eliminates chickenpox and adult shingles. It’s a standard childhood vaccine in the US and has been for some time.

As someone who’s suffered though fairly severe shingles twice, I’m a fan of this being eliminated.

Interestingly the reason the NHS has for this is vaccination can result in giving adults shingles (I simplify: https://patient.info/news-and-features/should-your-child-hav... explains).

As a result shingles seems rarer in the UK (no data, from personal experience, never heard of anyone getting it).

That doesn’t make any sense though. Make the kids suffer chicken pox AND shingles as adults do adults don’t get shingles as often? Anyone who contracts chickenpox as a child is able to get shingles as an adult. Inversely, anyone who gets the chickenpox vaccine as a child is unable to get shingles as an adult.

Kids that are vaccinated for chickenpox can’t get shingles as adults. That’s a really poor way to optimize.

Adults can also get shingles vaccines, which exist, and are safe, but are only given generally to elderly and very immunocompromised.

Shingles is not common in the US, I’ve had it twice due to an extremely stressful job: I’m perhaps an outlier as I got it in two places at once (1% of people get this) and one of which was in my eye, almost causing permanent blindness. This would never have happened at all had the vaccine existed when I was a child and I was vaccinated.

Yes. Very young children have a different type of immune system. They are simultaneously highly resilient to some viruses that can kill adults, while being highly susceptible to other infections that adults can handle.

Immunity and level of exposure are very tightly coupled. Children would ordinarily be exposed to a variety of viruses from birth. Most encounters with a virus happen at very low viral load (e.g. total number of virus particles you're exposed to). During lockdowns, the diversity of viruses that children were exposed to dramatically dropped. Newborns and young children were now only exposed to viruses that were already in their household. Hence, young children have likely developed immunity to a smaller pool of viruses.

Once lockdowns ended, they were then exposed to many viruses their immune systems had never seen. Some of these exposures would be at low viral load, giving them a chance to build immunity. Some of these exposures would be at high viral load, overwhelming their immune system and leading to illness.

It’s not as if kids coming out of lockdown are suddenly exposed to a disproportionately higher number / load of virii than if they were exposed at a younger age.

What do you mean, exactly? Yes, the situation seems to be that kids coming out of lockdown are suddenly exposed to a disproportionately higher number of new virii in a short time than if they had been gradually exposed to them over the previous two years.

I mean that the viral loads they'd be exposed to in year 3 (post lockdown) would be the same as the loads they would have been exposed to in year 1 if there had been no lockdown.

A person's immune system is different in year 1 than in year 3 (and in basically all other variations of N and N+2).

It appears that children not getting sick in the first few years of their lives paired with some mutations that aren't uncommon can cause the immune system to stay too weak. This is one of the leading theories why so many children get Leukemia. This is a pretty serious scientific study on the phenomenon:

https://www.nature.com/articles/s41568-018-0015-6

The thymus comes to mind as a factor. As we age, the thymus shrinks. Children have a larger thymus which aids in combating viruses. Perhaps if these children had been exposed earlier, no hepatitis would have occurred.

I'd like to see if these cases would have occurred anyway in the preceding years. It may be that cases that were normally(hypothetical numbers for example purposes only) 1/1000 before lockdown went to 1/10,000 during, and after, went to 1/100. Taking the average over a 10 year period, this may be totally expected and not too concerning. If this is true my first point is incorrect.

It means if those children missed exposure to those common viruses, in a less than 2 years window, their liver will be destroyed???

Wow, wow, wow, this would be VERY nasty, and it would mean that we must be SURE those children get exposed in the right time window????

I can't find a reference right now, but delayed exposure is thought to be one reason why polio turned into a severe disease. Polio has been endemic in humans for generations, but it started causing severe disease in the late 1800's/early 1900's.

Previously, infants were exposed to polio, but increasing hygiene meant that exposure would be delayed.

Again, I can't find a reference for this now, so I'm probably getting details wrong.

The Glasgow University post: https://www.gla.ac.uk/news/headline_863600_en.html

Scottish study (Adeno-associated virus 2 infection in children with non-A-E hepatitis): https://doi.org/10.1101/2022.07.19.22277425

I was unable to find the UCL (London) study, but the above DOI references UCL faculty.

I wonder why they singled out A and E, shouldn't it be non-A, non-B, non-C, non-Delta, non-E hepatitis. It's been a long time since you could call hepatitis C "non-A, non-B hepatitis". Though this is in children, they probably should not be getting hepatitis C unless something has gone horribly wrong, so it might be okay to exclude that one, and hepatitis Delta is obscure, though is does show an analogue with this because the coinfecting "helper" with Delta is hepatitis B virus.

IIRC from the previous discussions, liver complications are more common following Hep-A or Hep-E infections. What was new about this wave of cases was liver complications without the known Hep A/E precursor.

This is a hypothesis based on a sample size of 9 and already in the comments people are treating it like gospel while pushing their political agendas.

Humanity is really (mostly) unfit to deal with both nuanced information and collective action problems.

You make a valid, and ultimately depressing point.

I see lots of commentators arguing about 'lockdowns', but very little discussion what actually constitutes 'lockdowns'. Lockdowns in China looked very different to lockdowns in Europa or lockdowns in the US. Lockdowns in 2020, in most countries, were very different to lockdowns in 2022.

> Humanity is really (mostly) unfit to deal with both nuanced information and collective action problems.

There is a point to be made that the number of collective action problems has increased, relative to one or two generations ago, and will further increase.

> I see lots of commentators arguing about 'lockdowns', but very little discussion what actually constitutes 'lockdowns'. Lockdowns in China looked very different to lockdowns in Europa or lockdowns in the US. Lockdowns in 2020, in most countries, were very different to lockdowns in 2022.

I'm not sure why I'm supposed to care about this distinction when they've all proven to be completely ineffective can-kicking at best, enormously costly interventions whose scope was extended well beyond their initial "15 days to slow the spread" mandate for precious little (if any) benefit and an accumulating roster of harms.

You are supposed to care because effect of policies no longer matters, only the intentions.

Pragmatism is apparently a forbidden concept in 2022.

>can-kicking at best

Covid deaths per 100k population

USA 311.7

New Zealand 40.27

Source: https://coronavirus.jhu.edu/data/mortality

This is what happens when you "can-kick" infections after vaccination (actually, not even after vaccination but after offering vaccines to the population - and a lot of them stupidly refusing them).

As I said:

>Humanity is really (mostly) unfit to deal with ... nuanced information

They've already weaponized the term "immunization debt" and are pushing it to attack researchers who are pointing out the exact same thing.

Why are there people with hammer and sickle in their handles suddenly claiming expertise and calling researchers nazis ?

> The two teams of researchers, from London and Glasgow, say infants exposed later than normal - because of Covid restrictions - missed out on some early immunity to:

> - adenovirus, which normally causes colds and stomach upsets

> - adeno-associated virus two, which normally causes no illness and requires a coinfecting "helper" virus - such as adenovirus - to replicate

> That could explain why some developed the unusual and worrying liver complications.

At face value, it sounds doubtful. The kid in the article is 3 now, so we can assume he was 1 when the pandemic started.

In former communist countries in Eastern Europe, maternity leave up to 3 years is not uncommon now, and was much less uncommon before the fall of the respective regime. Of course kids would be taken out and play with others at playgrounds even if there's no kindergarten and the mother takes care of the kid for 3 years, so it's not total isolation. But the pandemic hasn't resulted in total isolation either, there were schools/kindergartens that opened at least for some periods of time, playgrounds too (past the initial lockdowns which were pretty much full panic mode). Those kids didn't spend 2 years locked at home.

So what's the difference? The masks? Did kids under 3 even wear masks?

Some of the kids would have been totally isolated, especially if they or a parent are otherwise classed as "clinically vulnerable". Or just very determined not to risk COVID.

Sounds like the difference may be circulating adenovirus and AAV-2.

I have doubts, too. There's lots of rural kids who didn't have much contact with others in infancy, pre-pandemic. Wouldn't this have shown up in them? Wouldn't it be part of the constant "advice for new parents" flood?

If you're rural enough to not have any infant contact, you're not talking about lots of kids, you're talking about a very small population. Even then, you're still probably going to be exposed to whatever community you are a part of. Very few people are actually "off the grid" in that respect.

Rural kids added up is a big enough population to see a difference in the stats.

When you go on maternity leave you don't stay in isolation with the kid, and the rest of your family continues to interact with many people as well. Copmare that to the past 2+ years where family units stayed isolated for long periods and then only interacted with masks, distancing and enhanced cleaning protocols. Chlidren globally most certainly avoided infections during this time, the stats for any children's hospital back this up.

> Those kids didn't spend 2 years locked at home.

Plenty of kids spent two years locked at home. Plenty of middle-class adults with remote jobs spent two years locked at home, with weeks at a time literally not opening a door to the outside.

In the two cases I know of relatively wealthy (upper-middle class developers) couples with remote jobs who had a child either in the year before or at the beginning of lockdown, they were 100x more isolated than the other people I knew.

I blame this on the hysterical coverage of infant covid deaths on the news, when the national numbers of infant deaths were something you could have counted on your fingers. Every infant death was national news for some stupid, obvious reason.

edit: And this was real isolation. People wouldn't allow relatives or parents to visit. They were more likely to get their mothers to move in and live with them than to let them visit (thinking about one of the two couples specifically.) This is the opposite of what normally happens with newborns.

> with weeks at a time literally not opening a door to the outside

That sounds very exaggerated. Do you think they stocked up on weeks worth of frozen food to survive?

Instacart dropped off at front door.

I think we can assume that pessimizer means that opening the door for the supermarket delivery doesn't count.

Amazon has a feature that if the customer allows it the delivery person can open garage place items inside garage and close garage door.

I must be very exaggerated, because I don't ever go to the grocery store more than once every two weeks. I've pushed it to a month or more many times out of laziness, but that's also when I clean out the back of my cabinets and learn new recipes.

edit: and the back of my freezer. You have to empty that thing periodically, and you're not going to choose that mystery meat in the ziplock willingly unless you're out of everything else.

> Every infant death was national news for some stupid, obvious reason.

I had a child born in March 2020. Given how new the virus was and how dangerous it was for the very old and the fact the we had virtually no information about how it would affect infants, I absolutely wanted to see that reporting. As sad as it is to hear about those individual cases, it was actually reassuring to know that the cases of infant deaths were so rare that it made sense to report on individual cases rather than just numbers.

The problem is that the overcoverage made it seem common, not rare.

Personally, that wasn’t my experience. The coverage didn’t make it seem common to me.

I was actually wondering if COVID measures could effectively lead to people losing immunity to things our immune system usually has little trouble with.

We evolved as social creatures being exposed to one another after all.

>We evolved

*Still evolving. Many people every day die from being exposed to other people's microbes and mishaps, even those who are weened on it. I wouldn't immediately justify and jump to the 'not socializing is deadly' argument.

What might really mess up your immune system is getting covid.

What evidence are you basing this on?

Junk pop science

I'm reminded of how polio paralysis only really became a thing with improved hygiene. Polio, for some reason, almost never paralyzes newborns. Until the late 19th century it was implausible to not get infected shortly after birth, and then constantly have that immunity built up with reinfection. But toilets and sewers changed that, and a child might not catch it until much older, where paralysis is a risk. Similarly someone in adulthood might have little immunity left, get a huge exposure eventually, and then develop neurological symptoms.

This is correct, not sure why it was downvoted. I think a major reason why people did not get very sick from poliovirus when very young is because of maternal IgG passed through the placenta before birth, and maternal IgA (edit, sorry, probably IgG through breast milk as well) passed through breast milk. This only lasts for six months and even by then it's waning, so children should get vaccinated with trivalent eIPV (enhanced Inactivated Polio Vaccine) as soon as their immune system is developed enough, probably by four months of age in enough cases to start giving the first dose. Some countries can't handle the cost and logistics of giving safe injections of eIPV, but you can't give multiple serotypes of OPV (Oral Polio Vaccine) at the same time because there is a dominance hierarchy that interferes with generating immunity against all serotypes, so at least one dose of eIPV should be used before starting OPV if at all possible. Polio has three serotypes without long-term protective cross reactivity, so you can't rely on natural infection to prevent future disease (possibly as a teenager or adult) caused by a different serotype.

Infant and youth mortality were really high until the 20th century[1]

Sometimes they weren't even named[2] or the deaths recorded[3].

[1] https://ourworldindata.org/uploads/2019/06/Mortality-rates-o...

[2] https://digitalcommons.kennesaw.edu/cgi/viewcontent.cgi?arti...

[3] https://www.jstor.org/stable/2173612

Yes, but that doesn't explain the steady increase in adult and older child polio paralysis seen in the first half of the 20th century. Cases peaked as the vaccine was introduced.

Sorry I don't know much about polio and don't fully understand the argument - how does it affect the overall risk-benefit ratio of Polio vaccination?

Any vaccine will have side effects negatively for that matter, how is Polio different in that regard?

I would think it strengthens the argument for vaccination. Adults and older children are at great risk of serious illness due to lack of childhood immunity.

If none of us had polio vaccines, it would probably behave today much as it did in the mid-20th century USA, with periodic waves of outbreak that would leave dozens or hundreds dead and tens of thousands disabled.

I have seen this perspective on polio before, with data. Can’t find it now, but wanted to add my experience for the downvoters.

This is going to terrify people just like stories about infant mortality from COVID terrified people. But the article is talking about infections of 1,000 children across 35 countries. These stories shooting to the front page over and over is giving a distorted view of reality that didn’t exist before social media.

You are right, but widely disseminating these findings is important in order to counter two equally damaging narratives: that acute hepatitis was caused by vaccines, and that it was caused by Covid. In the end, the authors speculate that lockdowns may have been the ultimate cause.

> talking about infections of 1,000 children across 35 countries.

Just to be accurate these are 1000 _reported_ cases, which are likely very _severe_ cases.

I have toddler age kids and I am not interely sure I would be able to distinguish this from another high fever infection.

Icteric skin is as far as I know not that noticieable in these cases. So, from a parents perspective, other than slightly whiter poop, without a physician and/or lab work, it would probably just look like one of the other thousands of diseases kids catch in daycare.

Remembers me about Acute Lymphoblastic Leukemia (ALL):

> Epidemiologic studies indicate that infections in early childhood may protect against pediatric acute lymphoblastic leukemia (ALL)... our results support Greaves’ hypothesis that delayed exposure to infections in early childhood increases risk of ALL. [1]

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100471/

After these pediatric hepatitis cases popped up, there was a vocal contingent of MDs and Zero COVID types on Twitter arguing that it showed the urgent necessity to do whatever it takes to protect children from SARS-CoV-2 infections. It's sad to think that this fearmongering is probably causing a lot of children not to get the pathogen exposure they need in early childhood.

That's a junk article based on a garbage paper making wild speculative claims that lockdowns prevented kids from exposure to cold viruses, somehow resulting in colds giving kids hepatitis.

If you read the full text of the paper here: https://www.medrxiv.org/content/10.1101/2022.07.19.22277425v... you'll see their sample size was insufficient and cherry picked. They only looked at nine (9) cases and fifty eight (58) control subjects. Furthermore, they don't specify their sampling criteria, but they do mention they did NOT include children that were vaccinated in the study. Why?

What we do know is that there is emerging evidence that both COVID and COVID vaccination dysregulate the immune system, allowing diseases (like shingles) that are normally suppressed by the immune system until later in life to suddenly appear in young people.

Scotland started their child vaccination program in January 2022, around three (3) months in advance of the "worldwide hepatitis outbreak": https://web.archive.org/web/20220124104228/https://www.nhsin...

They need to redo the research, but use a much larger RANDOM sampling of all children who came down with hepatitis, and look for correlations with both COVID infection and COVID vaccination against hepatitis infection.

My educated guess is that it had little to do with lockdowns, and much more to do with immune system dysregulation from both COVID and COVID vaccination.

The path to hell is paved with good intentions.

I fail to see the good intentions behind not letting you go outside.

Nothing new under the sun - the Hygiene Hypothesis [0] at play!

[0]: https://en.wikipedia.org/wiki/Hygiene_hypothesis

The cause seems to be social distancing preventing necessary exposure to two types of adenovirus.

Sounds like another 2nd-order effect from lockdowns that has been disproportionately harder on children than adults. Really glad I moved out of my “pro lockdown” state.

~1000 children have this so far, and many have not required a transplant.

How many children lost a caregiver due to covid? 140,000. Thousands have lost both parents and are now orphaned.

Not to mention the children who have also died of covid.

Indeed, ~1000 worldwide had any sort of hepatitis at all, whereas over 400 have died from Covid in the U.S. alone.

Even if their theory is right about isolation being the cause of the hepatitis cases, then it was still the right thing to do in terms of risk vs. reward.

I'd rather have 2nd-order effects from lockdown than 1st order effects from the 'rona. So would all those that died or ended up with long term effects from contracting the disease.

I mean I disliked the lockdown as much as the next guy, but I would've wanted them to be harsher early on so the disease wouldn't have been allowed to spread and mutate in the first place. Instead, we got SOME measures, that proved to be effective, only for them to be lifted when the disease was nearly gone - every time they lifted restrictions there's been a huge surge in cases, undoing the effects of the measures, and making those who were in favor and sticking to the measures really jaded with the governments' policies.

It's like, you're not supposed to stop an antibiotics treatment when you're feeling better.

The disease was never "nearly gone". From the time the first carriers left Wuhan, we were all inevitably going to be exposed. The lockdowns were pointless collective punishment that did more harm than good.

The antibiotics are a good analogy. It does feel like we rushed back “out” into the world at the first sign things were “better”.

> Really glad I moved out of my “pro lockdown” state.

I haven't.

This issue affected 1000 thousand people in 35 countries. Did anyone die from this?

Covid on the other hand has killed 6 MILLION. Covid could've been solved in 1 month if everyone would just stay home for 1 month. Unfortunately, because of people like you spread noise, we're still stuck with this for the foreseeable future.

In addition, let me just comment how mathematically stupid it is to take the 1st order effects just because you're worried about the 2nd order effects.

> Covid could've been solved in 1 month if everyone would just stay home for 1 month.

No, it couldn't. And even if it could've, that would be impossible.

Believe it or not, places outside the US did do a 'real lockdown' for a lot longer than a month, and it didn't 'solve' covid.

It's not a real lockdown if I see people on the street.

Even Deborah Birx admits in her book that two weeks to slow the spread was a ruse:

>Birx writes “No sooner had we convinced the Trump administration to implement our version of the two-week shutdown than I was trying to figure out how to extend it.”

https://www.gulf-insider.com/top-us-health-official-admits-t...

> Believe it or not, places outside the US did do a 'real lockdown' for a lot longer than a month, and it didn't 'solve' covid.

If other countries harbour the virus then that won't eradicate it (and the countries with lockdowns will re-import it at some point).

As I indicated to dfbsdfbwe2ef2e, I think at this point in history it's really more interesting to get precise data, modelling. Not just to understand what could or could not have been done in the case of COVID-19, but also for the future, the next pandemic (or OK, even still COVID-19, if you're worried about the renewed rise), so that people will have a better foundation to discuss what the best path forward is.

Bickering about some imprecisely passed-around details doesn't seem to have any benefit at this point.

This virus can also live in and be transmitted by animals.

You going to lock down all the wild animals in the environment too?

Lockdowns have zero chances of working and were dumb from day one. We got played by China - voluntarily kneecapped our economies after falling for the political theater they put on for us welding apartments shut and all that. I find it fascinating that so few still seem to ignore that they shut down internal travel but still allowed travel outside their country. Nothing suspicious in that at all.

> Lockdowns have zero chances of working and were dumb from day one. We got played by China

"Bickering about some imprecisely passed-around details doesn't seem to have any benefit at this point."

I mean, maybe there was an effect as you say, and then just maybe that was done by them on purpose, but then the interesting bit would be to prove the hypothesis as well as you can. It would be better if even you at least said "I find this suspicious", over leaving it to the reader to feel like he has to agree or something. This kind of talking is heating up a discussion, for what benefit?

I do agree with you that the 1000 people are a drop compared to the millions (although those were young children, thus making for a longer duration of life potentially destroyed or disrupted individually).

> Covid could've been solved in 1 month if everyone would just stay home for 1 month.

Citation needed.

It will be interesting to see some proper knowledge (including numbers and mathematical modelling) around this. But this virus was very contagious, even at the beginning, and as soon as

> In addition, let me just comment how mathematically stupid it is

HN guidelines: "Be kind. Don't be snarky." "Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize."

(Also, your argument looks bogus since if there are multiple second-order effects with as much or higher (total) destruction then it would in fact be better to accept the first-order effects, no? Yes, that's probably not the case here, but your argument is that it's "mathematically" stupid, which does not appear to be the case.)

I would prefer if people stayed a little calmer and more rational on HN (not just you).

Did COVID really kill 6 million? At least in the US hospitals got extra funding for any patient identified with COVID so you routinely saw deaths (like gunshot wounds!) attributed to COVID when COVID clearly wasn't the primary cause.

Because of the ridiculous politicization of COVID and the response to it I take NOTHING at face value since every time the "experts" make an assertion, those assertions change months (if not weeks) later. Just look at the ridiculous evolution of masking guidance. How the vaccine story evolved from you won't get it it to you won't spread it to well, maybe your symptoms won't be quite as severe to the real truth after the FDA and Pfizer were forced to provide the background documentation after getting sued that the vaccines are less than 20% effective. What a shock - big phrama that has already had to pay out billions in the past for lying was lying again?

Excess deaths worldwide are more than 20 million and most of them are COVID deaths since excess deaths track covid cases well pretty much everywhere.

So, yes, covid did indeed kill way more than 6 million.

There has been very questionable counting of the deaths in Canada, as well.

For example, according to the public health unit of Canada's most populous city:

"Individuals who have died with COVID-19, but not as a result of COVID-19 are included in the case counts for COVID-19 deaths in Toronto."

https://twitter.com/TOPublicHealth/status/127588839006028596...

Did running away from those you disagree with solve all your problems? What happens when you disagree with officials in your state? Run away again? Does everyone and everything have to acquiesce to your understanding of the world? Do you think moving to live amongst those you agree with, while casting those that live elsewhere as "others" is a trend that will work out well for society in the long-term?

This feels like half of the answer.

> Scientists have ruled out any connection with coronavirus or Covid vaccines.

Well, that's a relief.

I just don't buy this.

Adenovirus positivity has not increased post-pandemic- and increases in infection are very likely due to increase in testing

https://pbs.twimg.com/media/FYg0p7JXoAEg7bw?format=jpg&name=...

Somebody explain that chart please?

A retrospective case-series study from Israel:

Long COVID-19 Liver Manifestation in Children https://journals.lww.com/jpgn/Abstract/9900/Long_COVID_19_Li...

The scientists say this in the original paper [0]:

> we cannot fully exclude a post-COVID-19 immune-mediated phenomenon in susceptible children

So explicitly not "ruled out".

[0] https://doi.org/10.1101/2022.07.19.22277425 - see PDF page 14

Isn't the _actual_ problem here the fact that these kids weren't vaccinated against hepatitis?

No because this wasn’t caused by hepatitis virus, but an adenovirus.

Why weren't they vaccinated against that then?

There aren't vaccinations against the common cold.

A better question is, were their immune systems dysregulated from COVID/COVID vaccination allowing these adenoviruses to cause hepatitis?

The paper did NOT investigate this possibility, and the claim that they proved that the two were unrelated is written in weasel speak.

What they showed was that COVID and vaccination did not DIRECTLY cause the hepatitis.

The elephant in the room is whether COVID and COVID vaccination dysregulated the kids' immune systems, allowing the adenoviruses to flourish and cause the hepatitis.

The number of commenters who read the headline and believed everything without reading the study critically is... disappointing.

The number of commenters that miss the difference in scale is disappointing.

This affected 1000 people in 35 countries.

Covid has killed 6 million people so far.

>Covid has killed 6 million people so far.

Based on what definition? The CDC admitted that 94% of the deaths attributed to COVID in the United States were deaths with COVID. The average age of death was the same as the average life expectancy in the US. The average COVID "death" had over two (2) serious comorbidities.

I question your number.

> The CDC admitted that 94% of the deaths attributed to COVID in the United States were deaths with COVID.

100% of deaths attributed to COVID are _also_ deaths with COVID.

What's your point?

My point is that the PCR tests used to diagnose COVID were dialed up to 40 cycles, which results in "positive" results even when there's no infectious material in the person. This caused 94% of the deaths, by the CDC's own admission, to be misclassified as COVID when the true primary cause of death was something else.

Should this be categorized as Hepatitis D and require an adenovirus vaccine then?

I had no idea the adenovirus vaccine provided immunity to hepatitis.

It does, to adenovirus caused hepatitis and heptitis B or D coincident with adenovirus infection.

The adenovirus infection ruins immune response to certain types of hepatitis viruses.

Scientists and doctors that warned about the health costs of lockdowns on children were cancelled. We really need to set up a Ministry of Ministry of Truth. /s

On a serious note, can we ask how we got here? Why were lockdowns so unquestionably pushed?

> No sooner had we convinced the Trump administration to implement our version of a two-week shutdown than I was trying to figure out how to extend it. Fifteen Days to Slow the Spread was a start, but I knew it would be just that. I didn’t have the numbers in front of me yet to make the case for extending it longer, but I had two weeks to get them. However hard it had been to get the fifteen-day shutdown approved, getting another one would be more difficult by many orders of magnitude.

Dr Birx from her book.

But she's far from the only one to blame.

1000 kids across 35 countries, versus the thousands dying every day in some single countries at the time.

Warning is one thing, being needlessly contrarian while conveniently not having to make a decision yourself is another.

> Scientists and doctors that warned about the health costs of lockdowns on children were cancelled.

Can you cite a few examples?

https://gbdeclaration.org/

The Great Barrington Declaration specifically mentioned physical health of children. It did not specify this particular type of situation though.

However, in this article the main author of the declaration did specify:

https://www.telegraph.co.uk/news/2020/06/27/lockdown-social-...

Here are the "cancelled" articles:

https://reclaimthenet.org/facebook-deletes-epidemiologists-b...

https://www.breitbart.com/europe/2020/10/13/big-tech-censors...

I was thinking it would be something along the lines of speaking engagements getting cancelled due to outside pressure. Sounds like there were some cases of them getting censored. Facebook and the like should be more transparent about the reasoning behind those decisions.

> can we ask how we got here?

- most people have a stupid bias towards "doing something, anything, doesn't matter if it doens't work"

- politicians and "thought leaders" and "experts" amplify this bias to bewildering extents of stupidity (mostly for selfish reasons, is something goes wrong and they "did nothing" they destroyed, if they do something wrong but it was "the established best thing to do at the time" they can just say "oops, we were wrong, but now we've learned from it, we all learn from our mistakes and grow")

- so we get the shitshow we have/had!

And doing some simple experiments to establish faster that eg. masks work was only very very late done - "not a priority to do stupid pseudo-science pseudo-experiments now, let our scientists focus on the important things".

Our effor to "control" (lockdown) or "prioritize" (oh no, there won't be any masks left for healthcare workers if everyone buys them) or "efficientize" ("let's not have thousands of independent vaccines and do wasteful overlapping studies") or "be ethical" (oh now, forget that we have ~100k pople offering themselves as volunteers for proper but faster vaccines testing, we can't just put them at risk to accelerate the process) turned everything to shit.

It's kind of obvious that if we want antifragility towards pandemic we need less-coordinated responses, more divergent thinking and more organically-organized common sense approaches even when the evidence for them is still lacking.

...instead we picked the technocratic-authoritarian playbook and our plan for a potential future even worse pandemic is to double down harder on the same path (wtf).

> Why were lockdowns so unquestionably pushed?

If memory serves me right, early on in the pandemic, the health care systems of a number of countries and cities (e.g. Italy, NYC) were completely overwhelmed by infected individuals with severe respiratory illnesses, many of whom needed several days of ventilator treatment to survive. Many aspects of society in these areas ceased to function because of the effects of the virus itself (and the effective collapse of the health care system). Support for government mandates grew out of a desire to mitigate the effects of the virus.

In the US, after a pretty devastating March 2020, government mandates were largely left to the states, meaning that states/cities more strongly affected by COVID were able to choose stronger mitigation strategies and vice-versa.

After we learned more about the virus, after a vaccine was developed & released, and after the virus mercifully mutated into a less lethal version of itself, the likelihood repeating the same sort of shock on the healthcare system dropped. Many states had already lifted their restrictions in 2020, and states that were hit harder early (e.g. NY, CA) gradually lifted their restrictions throughout 2021.

I interpret Dr. Birx's quote to suggest that she believed that "fifteen days" time was not enough time to slow the spread, and that this was the largest span of time for which she was able to obtain authorization. The later expansion to "thirty days to slow the spread" suggests that Dr. Birx was correct.

I'll also note that, the following month, the President of the United States suggested that citizens should "LIBERATE MICHIGAN!" of their mask mandates and business restrictions. From this, your claim that mask mandates were "unquestionably pushed" seems inaccurate to me. On the contrary -- the first year of the pandemic was a perpetual deliberation on the effectiveness of mitigation strategies. Lockdown strategies continue to be debated despite lockdowns being basically nonexistent in most of the US now.

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